# Creative Arts Therapy for Anxiety, Depression, and Quality of Life in Cancer Patients: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

## TL;DR

Creative arts therapies may help reduce anxiety and depression and improve quality of life in cancer patients, according to a review of 67 trials.

## Contribution

A systematic review and meta-analysis of randomized trials evaluating the efficacy of creative arts therapies in cancer patients.

## Key findings

- Creative arts therapies showed significant reductions in anxiety and depression across multiple time intervals.
- Quality of life improved in cancer patients receiving creative arts therapies, particularly in the short to medium term.
- Most interventions were music-based and conducted in North America, with low-to-very-low certainty of evidence according to GRADE assessment.

## Abstract

Cancer is a significant psychological burden for patients. Previous evidence syntheses suggest creative arts therapies (CATs) may improve psychological outcomes, but are limited by heterogeneity in intervention types, study designs, and outcomes, and the lack of a certainty of evidence assessment.

We conducted a robust systematic review and meta‐analysis of current randomized trial literature to explore the efficacy of CATs in improving anxiety, depression, and quality of life in cancer patients.

We searched PubMed, Embase, and PsycInfo databases for peer‐reviewed randomized trials evaluating the effectiveness of CATs against a control in patients with current cancer diagnoses. We performed pairwise random‐effects meta‐analyses of standardized mean differences (SMD) for anxiety, depression, and quality of life, stratified by time‐interval. We conducted subgroup analyses by session frequency, intervention type, treatment setting, and region. For studies not pooled quantitatively, results were qualitatively summarized.

67 randomized trials with 6259 patients were included. The majority of interventions were music‐based (80.6%), multi‐session (59.7%), inpatient‐based (73.1%), and conducted in North America (29.9%). Meta‐analyses demonstrated positive effects of CATs on anxiety at < 7 days (SMD = −0.62 [95% CI −1.01, −0.24]), 4–6 weeks (−1.21 [−2.08, −0.34]), and 2–3 months (−1.19 [−2.14, −0.24]); depression at 1–3 weeks (−0.44 [−0.87, −0.00]) and 4–6 weeks (−1.14 [−1.76, −0.52]); and quality of life at 1–3 weeks (0.65 [0.05, 1.25]), 4–6 weeks (1.17 [0.02, 2.32]), 2–3 months (1.42 [0.55, 2.29]), and 4–6 months (0.42 [0.04, 0.80]. Qualitative results corroborate these findings. GRADE assessment revealed low‐to‐very‐low certainty of evidence.

Creative arts therapies may improve anxiety, depression, and quality of life among cancer patients.